Prostate health begins with regular screening

Special to U-T San Diego

Unlike obesity, diabetes and heart disease, prostate disease is a health concern that’s entirely unique to men, and primarily found in men older than 55. Prostate cancer — a disease in which malignant cells form in the tissue of the prostate — is one of the most common types of cancer diagnosed in men in the United States, second only to non-melanoma skin cancer, according to the Centers for Disease Control and Prevention.

More than 200,000 American men are diagnosed with prostate cancer each year and the disease claims the lives of more than 28,000 men annually, making it one of the leading causes of cancer death among men of all races. Becoming informed about prostate health, as well as having regular consults with a urologist or primary-care physician, can help older men stay healthy.

The American Urological Association released updated guidelines for prostate cancer screening at its annual meeting in San Diego in May, recommending that men ages 55 through 69 with an average risk of developing prostate cancer receive prostate-specific antigen, or PSA, blood tests every two years.

However, men with an increased risk of developing the disease, such as those who have had a close family member — father, uncles, brothers or cousins — diagnosed with prostate cancer and men of African-American ethnicity, are recommended to begin the screening process earlier, at age 45. Men in these two groups are also more likely to develop more aggressive forms of prostate cancer, according to Dr. J. Kellogg Parsons, a urologist and associate professor of surgery at the UC San Diego School of Medicine.

Parsons, who also sits on the National Comprehensive Cancer Network for the Early Detection of Prostate Cancer panel, is quick to stress that prostate cancer screening guidelines are just that, and that screening itself is not without risk.

“Every decision to screen, every decision to check a PSA blood test, needs to be made in the context of the conversations with your doctor,” Parsons said. “You have to discuss the benefits and potential risk of screenings with your doctor and come to a decision about whether or not screening is the best choice for you.”

Potential side effects to prostate cancer treatments include urination and erection problems. It’s up to patients to discuss both the risks and benefits with their doctor to determine when, and if, to begin screenings or treatments.

Even in the event that prostate cancer is detected, aggressive treatments may not always be necessary.

“There are a lot of prostate cancers that don’t necessarily need to be treated right away,” Parsons said. “There’s something called active surveillance, or watchful awareness, and a lot of men qualify for that. Those are men who do not have aggressive prostate cancers who may be safely monitored without specific treatments, and that is another alternative that we talk to patients about.”

Men should also be aware of another potential, but non-cancerous, prostate concern: Benign prostatic hyperplasia, or BPH, which affects up to 75 percent of men by the time they turn 75. Symptoms include going to the bathroom frequently, getting up at night to urinate, difficulty urinating and urinary infection.

“(BPH) is not something that you can necessarily screen for; it’s something that men should talk to their doctors about as they develop the symptoms because there are various ways to treat it,” Parsons said.